main question - does your spouse has h1 or EAD / Green card . if it is EAD and above , then go for it. arrange a nanny for kids , cook for food. slowly ask H to move to your place. it might take 6 months, but since visa issue is not there, it is possible if not , can't advise . since i am not sure , how long is this study and then residency practise. who is managing the finances, did you get a loan from college with scholarship. overall go for it. if it is just 4 years, time flies. you will regret more of not doing than doing it. when going for it, be supporting of your spouse. i understand you are in lot stress, but he will also have, managing kids all the itme and work is equally stresfull. arrange for cook and nanny . this is not time to be emotional, please think without emotions and analyse everything. sorry if my views are all over the place.